Nutritionist Federica Amati takes food very seriously, strictly limiting ready meals, fizzy drinks and emulsifiers at home with her supermodel husband and their young children. The link with the rise in bowel cancer in the under-fifties is too strong, she tells Damian Whitworth.
When one of the United Kingdom’s leading nutritionists met and fell in love with the original male supermodel, the result was not a marriage of convenience food.
Dr Federica Amati is the bestselling author of Every Body Should Know This and head nutritionist at Zoe, the health science company founded by Tim Spector, professor of genetic epidemiology at King’s College London.
She is married to Paul Sculfor, who in the Nineties was the first man to be dubbed a “supermodel” and was the face of campaigns for Versace, Christian Dior, Paul Smith and others, while dating Jennifer Aniston and Cameron Diaz. Now almost certainly the most handsome 53-year-old in Britain, he hosts a podcast on addiction, drawing on his own battles from many years ago, and is, according to Amati, “aligned” with her approach to healthy eating.
The couple have two daughters, aged six and four, and together they eat a rich and varied diet. But there are some things that Amati does not allow to pass her children’s lips. “I don’t see any benefit to drinking a cola at any point in life. That’s something that I’m very black and white about. I don’t see any reason for even trying them. Fizzy drinks are the worst ultra-processed food [UPF] that exist. Full of artificial additives, full of sugar. It’s insane how bad they are.”
And she takes a similarly hard line on flavoured yoghurts. “Children’s yoghurts have some of the highest sugar content in the food industry.” Have your children ever been to McDonald’s? “No.”
You may be the healthiest household in Britain, I suggest. “It depends what you mean by ‘healthy’. I’ve got two daughters and it’s really important that they have a good relationship with food. I grew up in an Italian household. I’ve always thought of food as a pleasure. There’s no ‘good food’ or ‘bad food’. It’s all part of the food culture. I don’t make my own sourdough. I don’t have my own kefir grains on the go. I’m not home-making everything. What I do have is an environment in my home where the majority of the food is whole food.”
But she confides that even healthy eating gurus have to let some things go. Take her husband. “Because of his line of work he’s always been aware that food’s important to feed his body. He loves to eat food that makes him feel good. He just has these quirks, like Tiptree brown sauce and marmalade and things that are just for him in the house. He’s not drowning every meal in brown sauce, but he will have it on occasion. There’s no reason to completely exclude foods for ever.”
In recent decades rates of bowel cancer (also called colon or colorectal cancer) have declined in people over 65. But they have increased in people under 50 by at least 50 per cent and deaths from the disease in this age group are set to be a third higher this year than in 2018. A number of factors may be contributing to this but suspicion centres mainly on our diet, especially ultra-processed food.
There’s increasing evidence of a link between colon cancer and disruption of our gut microbiome, the ecosystem of microbes that live in our intestines. Some specific microbes may even be important in the initial development of a cancer.
Amati, who is nutrition lead at Imperial College London’s School of Medicine and a research fellow at King’s College London, is involved in ongoing research by Zoe that last year provided the most in-depth map of gut bacteria.
She highlights the potential danger of emulsifiers. While cautious about the scientific work that has been done so far, because it has mostly been in mice, she says that studies show that emulsifiers appear to cause an imbalance in gut microbes that promotes inflammation, making them a suspect in the rise in cases of irritable bowel syndrome and possibly cancer.
Emulsifiers can be found naturally in things like eggs, but most of those in processed foods are produced industrially. These emulsifiers are used to improve shelf life, create smooth texture and prevent separation. In a natural yoghurt, for example, there will often be a watery layer at the top of the pot, but emulsifiers eradicate such natural separation from many yoghurts, which apparently appeals to those unhappy at the prospect of simply stirring the tub.
Emulsifiers are in more than half of all ultra-processed foods. Look on the back of the packaging and you will find such wholesome-sounding ingredients as lecithin, mono and diglycerides of fatty acids, diphosphates, xanthan gum and pectin. One recent study found emulsifiers in 95 per cent of pastries, buns and cakes, helping them stay softer for longer; 81 per cent of desserts; and 77.5 per cent of confectionery. Half of emulsifier-containing products include more than one type of emulsifier.
“Many of us consume a cocktail of them every day,” Amati says. If the back of the pack has lots of ingredients you don’t recognise, “It’s a sign maybe to stop and think, ‘Do I need to buy this?’ "
The UPFs containing emulsifiers are also likely to have other artificial additives, and will probably be high in sugar and sodium and low in fibre, healthy fats and polyphenols, the defensive phytonutrients or plant chemicals found in plants, Amati says.
Adults in wealthy countries like the UK and US now get more than half their calories from ultra-processed foods and the percentage is higher in children — British kids consume the highest level of UPFs in Europe. It is especially high in those who have packed lunches, secondary school pupils and those from lower income families.
It has become all too easy to fall into the UPF habit. Amati sketches a recognisable portrait of a day in the life of a commuter who grabs a Pret croissant on the way to the office and for lunch buys a Tesco meal deal of a sandwich, packet of crisps and a fizzy drink. “Then a protein bar on the way home, because they’re probably knackered from eating an unhealthy diet. And then when they get home, it’s not unusual to pull out a ready meal or a frozen pizza. It’s very easy to see how we’ve slipped into having a very highly processed junk-food diet.”
Some people won’t buy anything containing an ingredient they don’t recognise. “I don’t think being that absolutist is actually helpful.”
The key is to follow a “minimally processed whole food diet. That means buying groceries as opposed to buying food products. Buying the original thing, whether it’s fresh, tinned, frozen or dried. If we use that to make the majority of our meals, then we’re in a place where the additional snack that we might grab or the dessert we’re enjoying with friends becomes a minority of our dietary pattern, an occasional addition. Once you start eating more of the foods that are good for you, you’re less likely to want to eat a whole Galaxy bar.”
I have to ask: can she eat a whole Galaxy bar? “I couldn’t personally. I’ve seen it done.”
At the breakfast table of their home in north London, a staple for her girls is “dippy eggs”. She will put olive oil on the toast soldiers although one of them prefers butter. Butter in moderation is fine, but “it would not be my preferred fat source”. Buttery croissants got negative press recently after a study highlighted how bad they can be for heart health. Amati allowed them on the table at a hotel this summer — “If it’s really good quality, I think it’s great to try foods” — but they are not a staple. She also does yoghurt and kefir bowls with fruit and nuts at home, and smoked salmon, high in salt and sugar, is an occasional treat. If they are still hungry the girls can have a handful of Shreddies, which are, she volunteers, very much not minimally processed, on the way to school.
At other meals half their plates would be whole plants. “Whether that’s leafy greens or beans or chickpeas, lentils, mushrooms, aubergines, tomatoes or frozen peas. Then a quarter would come from a carbohydrate source, like whole grains, sweet potatoes — tubers absolutely have a place as well; there’s no harm in having them as part of it. And then the last quarter is a protein source, whether that is fish — oily fish is the preferred animal protein — chicken, or maybe it’s eggs, tofu, occasional red meat. Once you’ve eaten all those foods, if you then go off and have a bit of Galaxy, I guarantee you won’t be anywhere near as hungry if you’ve eaten those foods in their whole form.” There she goes again, talking about that Galaxy bar.
They all eat fish and her kids love sea bass and her husband’s kippers. She cooks fish pie. Because she doesn’t eat meat, her lasagne will be half-filled with mushrooms and beans, with some meat in the other half. “My kids and my husband love to eat meat when I make it for them, but we don’t have it very often. My approach is to buy the highest quality I can.”
Amati, 37, was born in Rome and moved with her family to London aged seven because her mother, a doctor, worked for the European Medicines Agency. She attended an international school, which stripped her of her Italian accent, and then read biomedical sciences at the University of Edinburgh. Aside from a stint working in PR and marketing in New York, she has been in academia and research, studying for a master’s and then a PhD at Imperial and another master’s, in nutrition, at the London School of Hygiene & Tropical Medicine.
Her interest in gut health is personal. Her father died a few years ago from colorectal cancer. “So I am warier of products like processed meat. But one of my daughters loves a ham and cheese sandwich occasionally, so I will buy freshly cut prosciutto cotto, which is just cooked ham and more expensive than your reconstituted, 80 per cent pork. The very cheap cold cuts are the ones to really watch out for.”
Because of her Italian heritage, she cooks a lot of pasta. Wholewheat, one assumes? Actually, no. Good Italian brands cost more but slow-dried durum-wheat pasta has a rough texture and a great taste. “The crucial thing is to have a really vegetable-rich, high-fibre sauce.” If you’re buying cheaper pasta brands, you’re better off getting wholegrain. Amati’s pizzas have a sourdough base.
She talks of a “new five-a-day”. These are: whole grains; legumes; fresh whole fruit; nuts and seeds; omega-3 fats. Eat these foods every day, she says, and you will immediately be eating more healthily than most of the population.
“Every time you eat you’re making a decision that’s either going to become an investment in your health or it’s going to detract from your future health,” she tells me. We are talking at Soho House’s outpost on the Strand, close to King’s College. For several minutes I have been eyeing the biscuit that arrived with my coffee and I confess that I am worried that this is not a good investment in my future. “But how much investment have you made today with the rest of your dietary choices?” she asks.
For breakfast I had some oats with stewed apples from the garden, I say smugly. Topped with coconut yoghurt. It was low fat and I know she doesn’t like low-fat products. “Why have the coconut yoghurt?” I panic and shamelessly claim it’s only in the fridge because the kids like it. “The fatty acids in coconut are saturated fat. So actually, not great for you. My advice is to stick to a natural yoghurt.”
For lunch I had a cheese, tomato and lettuce sandwich. Gruyère, mature cheddar or parmesan would have been better for my gut microbiome than the supermarket cheddar I had. I show Amati the ingredients of the multiseed sliced loaf from the supermarket I used, which I know include emulsifiers to prolong shelf life. She notes the loaf is also high in sugar. “We don’t need added sugar anywhere in the diet and not in bread.”
If you’re buying packets of bread, she favours flat rye breads that you need to toast. “But they last for a week in the fridge, because they have high fat content from the seeds. They’re high in fibre and plant protein, there’s no added sugar and they don’t have emulsifiers. Yes, it is more expensive and you get much less bread.”
We should consider reducing how often we make bread the basis of meals. “It is not the only option for a carbohydrate that we should have in our repertoire. Whole grains are so cheap and take the same time to cook as rice.”
I need to think about this dietary revolution. But, more urgently, can I get away with having the biscuit? “You can get away with that biscuit, but you need some more fibre in your day. Maybe lentils.”
My coffee, by the way, is nothing to worry about. Amati loves coffee. “When we look at population data, coffee drinkers as a whole live longer, have reduced risk of cardiovascular disease and reduced risk of type 2 diabetes.” That goes for decaf drinkers and those who have milk in their coffee. “It doesn’t translate if you start adding syrups and sugars.” She celebrates the polyphenols and the fibre that you find in coffee.
According to Amati, 90 per cent of us don’t get the minimum recommended 30g fibre a day. Given that an apple only contains 2.4g and a bowl of porridge 4g, that doesn’t seem so surprising.
Amati is a big fan of beans and will have butter beans or borlotti beans with her morning eggs, topped with Daily30+, a plant-based supplement she devised for Zoe that contains more than 30 plants and 5g fibre per scoop. What about Heinz baked beans? “Personally I don’t. I find them far too sweet. But if Heinz baked beans is how you get your beans, you’re much better off having those beans than not. My husband loves his baked beans. But he’s not eating baked beans as the only source of legumes.”
I like the sound of Sculfor and his unshakeable devotion to the great bastions of British cuisine. At the height of his ubiquity in the Nineties, he was the face of a Banana Republic campaign shot by Bruce Weber and he looked down on Manhattan from the side of buildings. Attitude magazine called him “the face that’s worth a million dollars”. He lived a life of private jets, yachts, homes in Miami, London and New York and very famous, very beautiful girlfriends. But the boy from Upminster, east London, whose family were market traders, was naturally shy and used drink and drugs to help him socially. Twenty years ago he had a breakdown after a cocaine binge and spent six months in the Priory.
A few years ago he met Amati in a nightclub where she, unusually, had had a drink and was dancing on a table. Perhaps it was that detail that led Hello! to refer to her in its coverage of their 2016 wedding as a “socialite” when she was a postdoctoral researcher.
Sculfor still models and in addition to his Stride foundation, which helps addicts, and podcast, he is a mindset coach. Amati grew up in a family where drinking didn’t extend much beyond a glass of red wine with Sunday lunch and her husband’s sobriety helps her to drink very little alcohol. “I would definitely say that being married to him has helped.
“Alcohol is a carcinogen and it is directly linked to increased colorectal cancer risk. So I drink very, very occasionally. If you’re having a glass of red wine or champagne once a month because you’re meeting with friends, that’s really not going to have a huge detrimental impact on your overall health, if you have an otherwise healthy pattern. You’ve got to have room for the red wine, you’ve got to have room for the dessert, you’ve got to have room for the McDonald’s, if that’s your thing, or the Pringles.”
According to Amati, in the UK 25 per cent of our calories come from snacks. If she is working late at the university, what is her snack of choice from the vending machine? “I bring walnuts with me or an apple or some dark chocolate. Certain foods, when we look at the price point, it does often reflect quality. And for me dark chocolate is one of those.”
Her eldest daughter loves ricciarelli, the Italian almond biscuits, and has them as an occasional “sweet treat”. Amati gives the girls the odd Candy Kittens sweet. On holiday in Italy they will eat “proper gelato”, but she is wary of soft-scoop ice creams that are full of emulsifiers.
“If we start being purist about it and attaching moral badges to food, it’s first of all stressful for us and removes the pleasure. And it’s damaging for our children to have this relationship where it’s very hard to decipher. ‘Good food/bad food’ is not a good message. When you start depriving yourself of foods you enjoy because they’re ‘bad,’ then that is a fast track to binge culture. Let’s focus on the things we need to put back onto our plates because we’re not having them.”
A key area of future research, Amati says, will be identifying microbes that are associated with cancer and then trying to combat them by eating certain foods that will improve the gut flora, along with seeking a better understanding of the complexities of how our food, sleep and movement have an impact on each other and our metabolic health.
In the meantime, she hopes to spread a simple message. “People don’t necessarily always appreciate just how much impact your diet can have on how you feel.
“What I choose to eat today is going to help me feel really good today, better tomorrow and is helping me in the future. If that’s our core way of going into it, it’s much easier then to have a consistent majority good diet, and then the fun bits happen around it.”
Well now, if we’re talking of the fun bits, I’m off to cook up a vast vat of barley. Maybe.
The hidden emulsifiers
Emulsifiers are food additives that are used to help mix two substances that typically separate when they are combined. They play an important role in the manufacture of food products, enhancing their appearance, taste, texture and shelf life.
Emulsifiers used in food production are either purified natural products, derived from plants or animals, or synthetic chemicals that have similar structures to natural products. For example, lecithin (E322), which is widely used in chocolate products, can be sourced from soya beans (oil), eggs, liver, peanuts and wheat germ. Pectin (E440) can also be naturally found in fruits such as apples and pears. About 60 additives in the category “emulsifiers, stabilisers, gelling agents and thickeners” are permitted in food. Below are some of their most common uses.
Bread
It is possible to make bread without emulsifiers but the result is often dry, low in volume and goes stale easily. There are two types of emulsifiers used in bread: dough strengtheners, such as diacetyl tartaric acid esters (E472e) and sodium or calcium stearoyl-2-lactylate (E481, E482); and dough softeners, eg mono and diglycerides of fatty acids (E471). Dough-strengthening agents result in bread with an improved texture and volume. Dough-softening agents allow increased shelf life.
Chocolate
All chocolate products contain 0.5 per cent lecithin or ammonium phosphatide (E442). These provide the right consistency so the chocolate can be moulded into bars. Sorbitan tristearate (E492) can delay the development of “bloom”, where the chocolate’s surface takes on an unappealing dull or white appearance due to being stored at too high a temperature.
Ice cream
Emulsifiers are added during the freezing process to promote a smoother texture and prevent rapid melting after serving. They also improve freeze-thaw stability. Mono and diglycerides of fatty acids, lecithin and polysorbates (E432, E436) are commonly used. All this applies to other desserts such as sorbet, milkshakes, frozen mousse and frozen yoghurt.
Margarine
Emulsifiers give margarine the required stability, texture and taste. To ensure that the water droplets are finely dispersed in the oil phase, mono and diglycerides of fatty acids and lecithin are widely used, as well as citric acid esters of mono and diglycerides (E472c), which prevent the margarine from splattering during cooking.
Processed meat
The main components of sausages are meat proteins, fat and water, which are bound together in a stable emulsion. Emulsifiers stabilise this emulsion and distribute the fat finely throughout the product. And in low-fat meat products, food additives are responsible for making them as pleasant as their full-fat counterparts. The food industry uses mono and diglycerides of fatty acids and citric acid esters for manufacturing processed meat.
Written by: Damian Whitworth
© The Times of London